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The role of sugar-sweetened beverages in the global epidemics of obesity and chronic diseases
Open accessAbstract
Sugar-sweetened beverages (SSBs) are a major source of added sugars in the diet. A robust body of evidence has linked habitual intake of SSBs with weight gain and a higher risk (compared with infrequent SSB consumption) of type 2 diabetes mellitus, cardiovascular diseases and some cancers, which makes these beverages a clear target for policy and regulatory actions. This Review provides an update on the evidence linking SSBs to obesity, cardiometabolic outcomes and related cancers, as well as methods to grade the strength of nutritional research. We discuss potential biological mechanisms by which constituent sugars can contribute to these outcomes. We also consider global trends in intake, alternative beverages (including artificially-sweetened beverages) and policy strategies targeting SSBs that have been implemented in different settings. Strong evidence from cohort studies on clinical outcomes and clinical trials assessing cardiometabolic risk factors supports an aetiological role of SSBs in relation to weight gain and cardiometabolic diseases. Many populations show high levels of SSB consumption and in low-income and middle-income countries, increased consumption patterns are associated with urbanization and economic growth. As such, more intensified policy efforts are needed to reduce intake of SSBs and the global burden of obesity and chronic diseases. Evidence from cohort studies and clinical trials supports an aetiological role of sugar-sweetened beverage (SSB) intake in the development of obesity and related chronic diseases. This Review provides an up-to-date view, considering the evidence, potential mechanisms and policy actions to reduce the global intake of SSBs.
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From Dietary sugar consumption and health: umbrella review (2023) · cites this paper as [27]
In the citing paper
“sugar consumption has been suggested to stimulate the secretion of endogenous opioids in the nucleus accumbens and to stimulate the dopaminergic reward system.27”
From Dietary sugar consumption and health: umbrella review (2023) · cites this paper as [27]
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“Until now, the evidence for the association between dietary sugar consumption and the risk of cancer has remained limited and controversial.27”
From Dietary sugar consumption and health: umbrella review (2023) · cites this paper as [27]
In the citing paper
“Evidence of sugar dependence in an animal model indicated that similarly to addiction to morphine and cocaine, rats with intermittent sugar intake had decreased concentrations of dopamine D2 receptor mRNA in the nucleus accumbens and showed the characteristics of addictive-like behaviours called sugar addiction.27 126”
From Dietary sugar consumption and health: umbrella review (2023) · cites this paper as [27]
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“First, while we consider heterogeneity in the policy response due to consumption levels, we are not able to account for other factors, such as, for example, income, which is associated with SSB consumption [1].”
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“SSBs are associated with a significant increase in non-communicable diseases, over-weight, and obesity in both adults and children across the globe [6,7].”
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“Systematic analyses of SSBs and added sugars (of which SSBs are a major source) indicate that SSB consumption influences body weight and increases the risk of death from all causes, as well as obesity, hypertension, cardiovascular disease, and metabolic syndrome (Malik and Hu 2022).”
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“So Coke already controls maybe 75% of the store as far as the product , doors , everything ” (Sales Representative 13)”
Influential
Metadata
- Authors
- Malik, V. S., & Hu, F. B.
- Affiliations
- Harvard University (US)
- Brigham and Women's Hospital (US)
- Corresponding author
- Malik, Vasanti S.
- Hu, Frank B.
- Venue
- Nature Reviews Endocrinology
- Published
- 2022-01-21
- Volume
- 18
- Issue
- 4
- Pages
- 205-218
- ISSN
- 1759-5029 (ISSN-L)
- 1759-5037
- PMC
- PMC8778490
- OpenAlex
- W4207002397
- Cited by
- 854
- References
- 155
- Citations by year
- 2026: 162 · 2025: 236 · 2024: 227 · 2023: 160 · 2022: 69
- FWCI
- 24.63
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Nature Reviews Endocrinology (publishedVersion, cc-by)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Keywords
- sugar-sweetened beverages, obesity, type 2 diabetes, cardiovascular disease, cancer risk, cardiometabolic risk, added sugars, weight gain, urbanization, low- and middle-income countries, beverage consumption trends, artificially sweetened beverages, level of evidence, biological mechanisms
- MeSH terms
- Sugars, Sugar-Sweetened Beverages, Cardiovascular Diseases, Chronic Disease, Diabetes Mellitus, Type 2, Humans, Obesity, Weight Gain, Epidemics
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